Individual provider Active NPI

Theresa Tai Ngor Chew, O.D.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1265423131
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
09873T Issued in CA
Practice address
781 Vallejo St
San Francisco, CA 94133
Phone
(415) 677-9930
Fax
(415) 677-9599
NPI assigned
Oct 31, 2005
Last updated
Jul 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 09873T CA Primary

Addresses

Primary practice location

781 Vallejo St
San Francisco, CA 94133

Mailing address

781 Vallejo St
San Francisco, CA 94133
Phone (415) 677-9930

Other identifiers 3

IdentifierTypeStateIssuer
1043474133MedicaidCA
SD0098730MedicaidCA
GSD004530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081230000327 CA Practitioner - Optometry 9739241746 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09873TCAMDOptometrist
9873CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clear Vision Center Optometry, Inc. Optometrist CurrentSince Sep 17, 2005 Accepting new patients
Crystal Clear Vision Center Optometrist PastSince Apr 7, 2005 Accepting new patients

Locations

781 Vallejo St
San Francisco, CA 94133
Phone (415) 677-9930

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1265423131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 VALLEJO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94133",
            "telephone_number": "415-677-9930",
            "fax_number": "415-677-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 VALLEJO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94133",
            "telephone_number": "415-677-9930",
            "fax_number": "415-677-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEW",
        "first_name": "THERESA",
        "middle_name": "TAI NGOR",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "09873T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043474133",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0098730",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GSD004530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.